The Nerve Center(Physicians' Lounge)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed in the July 26-27, 2008 issue of The Mississauga News under the feature: Health & Wellness, Medicine Matters.

Dr. Peter W. Kujtan

Medicine is an art as much as it is a skill. During residency
training, it was a given that we pretty well lived at the hospital. No
rules existed about how many hours a week one worked. Work was the
essence of education. Every second or third day was often 32 hours
long. In those days, many of the hospitals where I trained were still
managed by nuns, as they did before the time of OHIP. The nerve center
of the hospital was the "Physicians' Lounge". This was the place that
doctors once congregated, particularly in the mornings. As residents, we
often drifted there at the crack of dawn. Not only was the coffee
there, but more importantly senior doctors congregated there. We would
sit, report and listen. We listened about past diagnostic triumphs,
about complex operations, about how to approach medical challenges. We
also listened and participated in other debates about politics, cute
new nurses and about opinions on things to come. The physicians lounge
was where we learned a great deal about medicine, but also about respect
for our senior colleagues. There was a pecking order, and the worst
infraction an intern could do was to arrive late or speak before spoken
to. I especially enjoyed the tales of medical life long ago, because
they were full of useful pearls about life. I cannot imagine a new
doctor undergoing training without years of study in the physicians
lounge. More business of health care got done in the doctors lounge
than anywhere else. It was one of the last places in the hospital where
face to face interactions take place between doctors. In doing hospital
rounds, it was a vital place to interact with colleagues, review
results, discuss consultations and generally retreat from the pressures that
practicing medicine can generate. Most importantly, it was where
hundreds of discussions about patients and their problems took place in
confidence. In the early days of my local hospital, family doctors even
slept there on couches when doing night deliveries or were on call. It
was a place where doctors were magnetically attracted to. Good
administrators knew that one key to keeping their medical staff happy
and motivated was to provide good basics in this sacred area. When
scouting out any new hospital, the doctors lounge is what a new doc will first ask
about and insist on seeing, because it defines the character of a
hospital.

But the point that I make is that this
institution of medical care has also gone the way of the dodo bird
with noticeable repercussions in many of our hospitals. At my local
institution, the physicians lounge started off in a brightly lit area,
where sipping coffee and greeting the sunrise was common. It soon "had
to" double as a mail room. Since coffee stains and mail don't mix, something had to go, and it wasnít the mail. Soon afterwards, the
proliferation of space for administrators crept into it, and any chance
for confidential discussions disappeared too. It didn't take long to
realize that the physicians lounge wasn't functioning anymore and was shut down for reconstruction. The coincidence was that a few years later, dozens of family doctors left. Eventually, a new "better" lounge was
built, this one without any sunlight or coffee and accessible only
through the secret knock on the back door of the mailroom. These days, busy
signals and endless days of waiting for call-backs from unfamiliar
colleagues have replaced the personal and efficient touch. The "new"
doctors lounge has lost its doctors, but maintained its pristine
composure, devoid of life, and stands as a sad reminder of "medical
progress".

Related resources:

● Relic or Relevant? From Minnesota Medicine. "The doctorsí lounge isnít what it used to be. In some cases, itís better."
● Doctors Lounge. Doctors Lounge was founded in April 2000, when two physicians, Dr. Tamer Fouad and Dr. Yasser Mokhtar, aspired to create an online medical community that would provide its visitors with free medical consultation.
● Doctors' lounge: A tradition slowly dies by Robert Lowes, from Medical Economics: Modern Medicine.
● Physician lounge bulletin boards. Request from a research specialist to share your ideas: "One of my hospitals is looking for effective communication to physicians in the physician's lounge. They currently have a bulletin board, but wants to know if there is a better way to communicate hospital happenings, events, news, etc. to physicians visiting the lounge."